PROJECT SUMMARY While several promising new vaccines are specifically targeted at the adolescent population, the successful delivery of these vaccines raises challenges. Adolescents are less frequently seen for preventive health services than other age groups, often do not have a connection with a traditional medical home, and may present for care without their parents, complicating issues of consent. Therefore, developing sustainable vaccination programs in complementary health care settings to supplement care received in a medical home is crucial to the widespread delivery of adolescent vaccinations on a population level. Schools offer an opportunity to deliver new vaccines to adolescents who may not have received them in their medical home. However, vaccines are expensive and schools have limited resources for health-related activities. Sustainable programs are needed which provide school-based vaccinations to eligible students in order to maximize immunization coverage for these vaccines. In the current proposal, a study team with extensive research experience in immunization delivery will investigate the feasibility, acceptability, and cost of implementing an adolescent vaccination program at eight middle schools in Denver and will develop a process for billing third party payers. This project will capitalize on the relationships being developed for a pilot project in late 2008 that will provide Tdap to eligible adolescents in eight middle schools in the Denver Public Schools (DPS) district. Using the foundation developed from this pilot project, we will develop the necessary strategies to implement and then evaluate a school-based immunization program in partnership with Denver Community Health Services that will vaccinate adolescents and bill third party payers. The program will plan to provide all adolescent vaccinations to eligible teens at eight middle schools in DPS and bill the appropriate insurer for the services provided. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE Several new vaccines are specifically targeted to adolescents, but successful delivery of these vaccines is a challenge since adolescents less frequently receive preventive health services. Sustainable programs in complementary health care settings are needed which provide adolescent vaccinations.